Cytology is useful in breast screening: results and long‐term follow‐up of the Singapore Breast Screening Pilot Project

Chew, Ivy; Tan, Yu Guang; Tan, Puay Hoon

doi:10.1111/j.1365-2303.2006.00328.x

Cited by 6 publications

(4 citation statements)

References 16 publications

(35 reference statements)

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“…Fibroadenoma and fibrocystic disease were the most frequent lesions included in the current and previously published series 31,32,34,52 (Table 6). Previous studies on screening series have demonstrated that greater numbers of 'pure' benign lesions are being excised 31,32 ( Table 5), but the increasing accuracy of preoperative diagnosis after the introduction of needle biopsy probably will lead to a decrease in this number over time.…”

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confidence: 99%

Benign breast lesions at risk of developing cancer—A challenging problem in breast cancer screening programs

Manfrin

Mariotto

Remo

et al. 2009

Cancer

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BACKGROUND:Cytology and core‐needle biopsies are not always sufficient to exclude malignancy in benign breast lesions (BBL) that are at risk of developing cancer, and open biopsy often is mandatory. In screening programs, open biopsies performed for lesions that are at risk of developing malignancy are considered benign. The authors of this report evaluated the impact of the screen‐detected BBL at risk of developing cancer that were counted in the quota of benign breast open biopsies in the Breast Cancer Screening Program of Verona.METHODS:Benign open biopsies were subdivided into 4 groups according to their risk of developing cancer: Histo1, normal histology; Histo2, ‘pure’ BBL (fibroadenoma, fibrocystic disease, mastitis, adenosis); Histo3, BBL with a low risk of developing cancer (radial scar, papilloma, papillomatosis, phyllodes tumor, mucocele‐like lesion); and Histo4, BBL with a high risk of developing cancer (atypical columnar cell hyperplasia, atypical ductal hyperplasia, atypical lobular hyperplasia).RESULTS:Of 510 open biopsies, 83 biopsies were benign, and the ratio of benign to malignant biopsies was 1:5. Histo1 was observed in 4.8% of all benign open biopsies, Histo2 was observed in 37.4%, Histo3 was observed in 31.3%, and Histo4 was observed 26.5%.CONCLUSIONS:BBL at risk of developing cancer may be numerous in screening programs. It is inappropriate to include BBL at risk of developing cancer in the overall benign open biopsy rate. The authors propose separating pure BBL from lesions at higher risk of developing cancer. To date, there is no evidence to support the premise that detecting high‐risk proliferative lesions leads to benefits in terms of reduced mortality; however, these lesions need to be counted separately for future evaluations. Cancer 2009. © 2008 American Cancer Society.

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confidence: 99%

Benign breast lesions at risk of developing cancer—A challenging problem in breast cancer screening programs

Manfrin

Mariotto

Remo

et al. 2009

Cancer

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“…It has been shown that the diagnostic accuracy of the integrated evaluation of physical examination, mammogram, and FNA approaches 100% . For the specific purposes of differentiating in situ from invasive ductal carcinoma in the setting of a palpable breast mass, a cytology specimen yielding malignant cells is almost always invasive cancer (∼98% of cases) .…”

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confidence: 99%

“…Studies have reported that the liquid‐based technique ThinPrep® (TP) has a sensitivity and specificity of 86%–100% and 74%–98%, respectively, for the diagnosis of breast malignancies . The comparison of TP with conventional smears has led to the identification of an array of artifacts related to the TP technique that could potentially affect the diagnoses in different organ sites . Here, we aim to highlight common diagnostic pitfalls and challenges of breast FNA cases with TP slides.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic dilemmas and pitfalls in ThinPrep^®cytology of breast fine needle aspiration biopsy:

Carniello

Pareja

Santos-Zabala

et al. 2017

Diagnostic Cytopathology

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Fine needle aspirations (FNA) of the breast for primary diagnoses have become less popular in the USA and are usually performed for lesions with low or extremely high clinical suspicion. They are also performed for lesions in close proximity to a breast implant. Liquid-based cytological preparations, such as ThinPrep® (TP), provide a practical alternative to clinicians who are performing FNA. Using a selection of cases that represent challenging diagnoses, we describe common diagnostic pitfalls of breast FNA that are specifically associated with this preparation. Well known breast cytology pitfalls, such as fibroadenoma, when solely examined using a TP slide can be even more challenging since the usual stripped bipolar cells seen in the background of smeared slides, can appear singly dispersed with preserved cytoplasm, resembling carcinoma. We describe that large fragments of solid papillary carcinoma are represented by mostly singly dispersed cells with plasmacytoid features that mimic those of a lobular carcinoma. Since nuclear features are more pronounced in TP, prominent nucleoli and cytological atypia can potentially be overcalled. TP processing might also lead to clumping of epithelioid histiocytes that appear atypical, which increases the suspicion of malignancy. The presence of atypical cells in a TP slide of a peri implant seroma should always undergo additional testing, especially in patients with a prior history of breast carcinoma, to determine if it represents recurrent carcinoma or an implant associated anaplastic large cell lymphoma. Familiarity with the aforementioned artifacts associated with TP is essential to avoid diagnostic misinterpretations.

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“…However, the Journal of the International Academy of Cytology has for some time now refused papers using the Pap classification. Several new forms of breast cytology reports were prepared in the 1990s, primarily by Western investigators [1][2][3][4]. It has been suggested that a new form for this kind of report in Japan should be prepared to meet these demands.…”

Section: Introductionmentioning

confidence: 99%

A new reporting form for breast cytology

et al. 2009

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The Cytology and Core Needle Biopsy Subcommittee, organized under the Rules Committee of the Japanese Breast Cancer Society, has prepared a new form for breast cytology reports. This reporting form consists of "diagnostic categories" and "recommendations." The "diagnostic category" is either "specimen inadequacy" or "specimen adequacy." The judgment on "specimen adequacy" is subdivided into four categories: "normal or benign," "indeterminate," "suspicious for malignancy," and "malignant." The "recommendation" indicates descriptions of cytological features and estimated histological type of tumor (these descriptions should be as detailed as possible). On the basis of an analysis of cytological data from 3,439 cases performed before preparing this form, the subcommittee has attached the following recommended goals to this form: (1) the percentage of "specimen inadequacy" should be 10% or less of all samples, (2) the percentage of "indeterminate" samples should be 10% or less of all "specimen adequacy" cases, and (3) 90% or more of "suspicious for malignancy" cases should be diagnosed as "malignant" in a subsequent histological examination. We hope that modification of this form, if it requires revision in the future, will be evidence-based, as was the process for compiling this set of rules.

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Cytology is useful in breast screening: results and long‐term follow‐up of the Singapore Breast Screening Pilot Project

Abstract: Although our FNAC results compared relatively well with international standards, they reflect a small cohort, and may face additional difficulties in a larger programme.

Cited by 6 publications

References 16 publications

Benign breast lesions at risk of developing cancer—A challenging problem in breast cancer screening programs

Benign breast lesions at risk of developing cancer—A challenging problem in breast cancer screening programs

Diagnostic dilemmas and pitfalls in ThinPrep^®cytology of breast fine needle aspiration biopsy:

A new reporting form for breast cytology

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Cytology is useful in breast screening: results and long‐term follow‐up of the Singapore Breast Screening Pilot Project

Abstract: Although our FNAC results compared relatively well with international standards, they reflect a small cohort, and may face additional difficulties in a larger programme.

Cited by 6 publications

References 16 publications

Benign breast lesions at risk of developing cancer—A challenging problem in breast cancer screening programs

Benign breast lesions at risk of developing cancer—A challenging problem in breast cancer screening programs

Diagnostic dilemmas and pitfalls in ThinPrep®cytology of breast fine needle aspiration biopsy:

A new reporting form for breast cytology

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Product

Resources

About

Diagnostic dilemmas and pitfalls in ThinPrep^®cytology of breast fine needle aspiration biopsy: